EP3308721A1 - Laparoscopic port site opening and closing device - Google Patents
Laparoscopic port site opening and closing device Download PDFInfo
- Publication number
- EP3308721A1 EP3308721A1 EP16891904.1A EP16891904A EP3308721A1 EP 3308721 A1 EP3308721 A1 EP 3308721A1 EP 16891904 A EP16891904 A EP 16891904A EP 3308721 A1 EP3308721 A1 EP 3308721A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- perforation
- closure
- cover
- rod
- penetrating tip
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
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- 210000000683 abdominal cavity Anatomy 0.000 claims abstract description 15
- 230000008878 coupling Effects 0.000 claims description 8
- 238000010168 coupling process Methods 0.000 claims description 8
- 238000005859 coupling reaction Methods 0.000 claims description 8
- 238000001356 surgical procedure Methods 0.000 description 8
- 238000000034 method Methods 0.000 description 7
- 210000004303 peritoneum Anatomy 0.000 description 6
- 210000001015 abdomen Anatomy 0.000 description 5
- 238000003780 insertion Methods 0.000 description 3
- 230000037431 insertion Effects 0.000 description 3
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 description 2
- 208000015181 infectious disease Diseases 0.000 description 2
- 238000002357 laparoscopic surgery Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000037361 pathway Effects 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- 210000001519 tissue Anatomy 0.000 description 2
- XUIMIQQOPSSXEZ-UHFFFAOYSA-N Silicon Chemical compound [Si] XUIMIQQOPSSXEZ-UHFFFAOYSA-N 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 229910002092 carbon dioxide Inorganic materials 0.000 description 1
- 239000001569 carbon dioxide Substances 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000006698 induction Effects 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 238000002355 open surgical procedure Methods 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 206010033675 panniculitis Diseases 0.000 description 1
- 238000004393 prognosis Methods 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 229910052710 silicon Inorganic materials 0.000 description 1
- 239000010703 silicon Substances 0.000 description 1
- 210000004304 subcutaneous tissue Anatomy 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
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- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0485—Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
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- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
Definitions
- the present invention relates generally to a laparoscopic port perforation and closure device. More particularly, the present invention relates to a laparoscopic port perforation and closure device configured such that a perforation device for perforating a laparoscopic port on a patient's body, a trocar for maintaining the port and allowing various surgical tools to be introduced therethrough, and a closure device for closing the port are selectively used in a single trocar assembly.
- laparoscopic surgery unlike conventional open surgical procedures, refers to a surgical technique where four to six incisions about 0.5 ⁇ 1.2cm in size are made in the patient's abdomen, and trocars, which have a diameter of 0.5 ⁇ 1.2cm and are 15 ⁇ 16cm long, are placed through these incisions.
- a light source, a camera, and surgical instruments are then introduced into the abdomen through the trocars. The surgeon performs the procedure, watching a television monitor to which the camera transmits an image of the organs inside the abdomen.
- a trocar site closure tool is used.
- the trocar site closure tool is configured such that the incisions are closed by stitching while the needle is held by the forceps that are placed into the abdominal cavity through the trocar.
- opposite ends of the surgical suture are pulled out of the patient's body through the trocar, and the knots are tied outside the patient's body. After tying the knots, the knots are formed into the abdominal cavity by pushing the knots using a compressor.
- the trocar is removed and the port is closed.
- Port closure can be done by direct suturing or by using a closure device.
- the perforation of the port by the trocar secures the operative pathway, and the closure of the port by the closure device is performed by using a separate device.
- a trocar is used to form a surgical port site
- the trocar 10 includes: a tubular sleeve 14 with a penetrating tip 16 penetrating therethrough; and a handle 12 provided at an upper portion of the sleeve, wherein an end of the penetrating tip 16 is constituted by a pointed end 16a to penetrate through subcutaneous tissue of an abdominal cavity, whereby after perforating a port, the penetrating tip is removed, various surgical tools are introduced through the trocar 10 to perform surgery.
- the trocar 10 is removed and the port is closed by using a closure device as shown in FIG. 2 .
- the closure device shown in FIG. 2 is well known to those skilled in the art, and the use thereof is gradually increasing since it provides safety allowing rapid closure of the port without failure.
- the closure device is also known as a fascial closure device.
- the fascial closure device which is in a tube shape for being introduced into a port site, includes: a tubular body 21 formed with guide groove 22 that face each other and guide insertion of a needle 23; and a pair of wings 25 being mounted to a lower portion of the tubular body, and being opened and closed using cam method, wherein each of the wings is provided with a silicon pad 26 at a location where the needle 23 penetrates through, and the wings 25 are configured to be opened by rotating an operating stick 24 and configured to be closed by reversely rotating the operating stick 4.
- the inventor of the present invention filed the document a laparoscopic port site closure device, which has a new structure that improves disadvantages of a conventional closure device, and it is registered as Korean Patent No. 1594082 .
- the laparoscopic port site closure device is configured such that a cartridge receiving a surgical suture therein is provided at a fore-end of a needle guide for port site closure; the surgical suture is caught in a needle tip that is pierced through a body tissue by being guided by the needle guide; and when the needle is withdrawn, the surgical suture is pulled out along a path through which the needle is pierced into the tissue, and the surgical suture is tied outside a patient's body, thereby being capable of closing a laparoscopic port site.
- the closure device includes: a tubular body provided with needle guides that face each other and guide insertion of a needle; wings mounted to a lower portion of the tubular body such that the wings are opened and closed through a cam method; and an operating stick penetrating through the tubular body to operate the wings by being rotated to push and open the wings and to pull and close the wings by being rotated reversely, wherein a replaceable cartridge is provided on a lower end of the tubular body to be detachably combined with the operating stick, and the cartridge is provided with the wings capable of being opened by operating the operating stick, and provided with a compartment for receiving surgical suture therein, whereby opposites ends of the surgical suture in the compartment are threaded through the wings such that the ends of the surgical suture are pulled out of a patient's body by being caught by a suture slot of a needle that is pierced into the patient's body from outside.
- the cartridge receiving a surgical suture therein is replaceable, whereby the port site can be easily closed without failure, and the closure device is reusable by replacing the cartridge receiving the surgical suture therein.
- the conventional closure device including the prior patent is limited to a closure device that simply closes an opened port, port opening and port closure are performed through different devices.
- the fascial closure device (the closure device) is introduced through the port site after removing the trocar to after surgery, the gas injected inside the abdominal cavity overly escapes, whereby the surgical space narrows so it is difficult to perform a follow-up treatment, the operation time may be long due to removal of the trocar and the replacement of the fascial closure device, which is an obstacle to the patient's prognosis.
- the present invention has been made to solve the above problem occurring in the related art that a function of the trocar and a function of the closure device are divided.
- the present invention is intended to propose a laparoscopic port perforation and closure device, in which a perforation/closure assembly being introduced in the abdominal cavity through a trocar sleeve is provided, thereby serving as both perforation of a peritoneum and closure of the opened port.
- the present invention is intended to propose a laparoscopic port perforation and closure device, in which a perforation/closure assembly replaced with a closure cartridge is inserted into a trocar sleeve without removing a trocar to suture, such that the reverse flow of the gas injected inside the abdominal cavity is minimized, whereby it is advantageous to stably secure the surgical space and suturing time may be shortened.
- the present invention is intended to propose a laparoscopic port perforation and closure device, in which an end of the body of the laparoscopic port perforation and closure device is provided with a detachable cartridge, such that the cartridge is replaceable after being repeatedly used, whereby it is easy to use and there is no risk of infection because it is discarded after reuse for the same patient.
- a laparoscopic port site closure device configured as follows.
- the perforation and closure device includes: a trocar configured such that a handle is coupled to a first end of a sleeve formed in a tubular shape for being introduced into a perforated port; a perforation and closure means hooked to the handle of the trocar and configured such that an end tip thereof enters an abdominal cavity by sequentially penetrating the handle and the sleeve of the trocar.
- the perforation and closure means may include: a hooked to the handle of the trocar; a bisected cover rod longitudinally extending from the handle; a holder provided therein and configured to rotate within a limited angle range in the cover rod and move up and down within a limited distance; a closure cartridge inserted into and locked to a lower portion of the cover rod; and a penetrating tip inserted into and locked to the lower portion of the cover rod or inserted into the lower portion of the cover rod and locked thereto by the holder, whereby the closure cartridge and the penetrating tip are selectively coupled to the perforation and closure device and are replaceable.
- the cover rod may be formed with helical needle guide grooves at an outer circumferential surface thereof.
- the penetrating tip may be provided with a pointed end to be coupled to an end of the cover rod, and an outer diameter of the penetrating tip may correspond to an outer diameter of the cover rod.
- the closure cartridge may include: wings coupled to an end of the cover rod and controlled by the holder to be opened and closed; and a compartment receiving a surgical suture therein, whereby opposite ends of the surgical suture are threaded through the wings such that the ends of the surgical suture are pulled out of a patient's body by being caught by a needle that is pierced into a patient's body from outside.
- the port opening function of trocar and the port closing function of the closure device are conventionally realized by the respective devices, but it is possible to realize the port opening and the port closing through a single device.
- the present invention is advantageous in that it is possible to serve as both perforation of a peritoneum and closure of the opened port after surgery through a perforation/closure assembly that is firmly coupled and easily replaceable.
- the present invention is further advantageous in that it is possible to solve the problem that the gas injected inside the abdominal cavity flows out through the port when a separate closure device is inserted to close the port after removing the trocar.
- the present invention is configured such that a perforation/closure assembly replaced with a closure cartridge is inserted into a trocar sleeve without removing a trocar to suture, the reverse flow of the gas injected inside the abdominal cavity is minimized, whereby it is advantageous to secure the surgical space constantly and suturing time may be shortened.
- the present invention is further advantageous in that since an end of the body of the laparoscopic port perforation and closure device is provided with a detachable cartridge, the cartridge is replaceable after being repeatedly used, whereby it is easy to use and there is no risk of infection because it is discarded after reuse for the same patient.
- a penetrating tip is configured such that an end tip thereof is exposed outside a second end of the sleeve by sequentially penetrating the handle and the sleeve of the trocar to enter an abdominal cavity
- a perforation and closure means is configured to be coupled to a closure cartridge by removing the penetrating tip and coupled to the handle of the trocar by a one-touch hook.
- the perforation and closure means is constituted by a combined perforation/closure assembly 3 detachably mounted to the trocar and configured such that the penetrating tip is coupled to an end thereof when opening (perforating) a port, and the closure cartridge is coupled to the end thereof when closing (suturing) the port.
- the perforation/closure assembly 3 includes: a handle cover 31 coupled to the handle of the trocar by a one-touch hook 32; a bisected cover rod 34 longitudinally extending from the handle 33; a holder 35 provided therein and configured to rotate within a limited angle range in the cover rod 34 and move up and down within a limited distance; a closure cartridge 36 inserted into and locked to a lower portion of the cover rod 34; and a penetrating tip 37 inserted into and locked to the lower portion of the cover rod 34 or inserted into the lower portion of the cover rod 34 and locked thereto by the holder 35, whereby the closure cartridge 36 and the penetrating tip 37 are selectively coupled to the perforation and closure device and are replaceable.
- the cover rod 34 is formed with a helical needle guide groove 341 at an outer circumferential surface thereof, and a plurality of the cover rods 34 is disposed to face each other and coupled to the handle cover 31 provided with the one-touch hook 32 therein.
- the cover rod 34 is configured such that upper and lower portions thereof are respectively provided with a coupling hook 342 and a coupling groove 343 to face each other, a plurality of the cover rods is coupled to face each other, and the cover rod 34 is provided with the holder 35 therein.
- the cover rod 34 is provided with a crank-shaped groove 345 at an inner upper portion thereof to form a lock/unlock constraint part 300, is provided with a step at an inner middle portion thereof to form a downward-motion constraint part 301, is provided with a step at an inner lower portion thereof to form a upward-motion constraint part 302, and is provided with a protruding piece 346 having an inner protrusion 347 at a lowermost portion thereof, thereby being formed in a tubular shape to form a neck entrance 303 at a lower end thereof when the cover rods are assembled to face each other.
- the holder 35 includes: a holding rod 351 provided with a step 352 under the handle with an upper diameter thereof large and a lower diameter thereof small; upper and lower protruding portions 353 and 354 provided at upper and lower portions of the holding rod; and a stopper 355 provided to protrude in a disc shape at a location right above the lower protruding portion.
- the upper protruding portion 353 of the holding rod 351 is engaged with a crank-shaped groove 345 of the cover rod 34, the step 352 is disposed at an upper portion of a downward-motion constraint part 301 to constrain downward-motion, the stopper 355 is disposed at a lower portion of an upward-motion constraint part 302 to constrain upward-motion, and an up-and-down moving distance of the holding rod 351 is constrained by the crank-shaped groove 345 and the upward-motion and downward-motion constraint parts 302 and 301.
- the crank-shaped groove 345 constitutes a lock/unlock constraint part 300 horizontally rotating at a location where the holding rod 351 moves up or down for locking and unlocking the same.
- the penetrating tip 37 is provided with a pointed end 371 and a neck 372 longitudinally extending upward at a center thereof to be detachably coupled to an end of the cover rod 34, and it is preferred that an outer diameter of the penetrating tip correspond to an outer diameter of the cover rod.
- the closure cartridge 36 includes: wings 361 detachably coupled to an end of the cover rod 34 by inserting a neck 362 thereinto and controlled by the holder 35 to be opened and closed; and a compartment receiving a surgical suture therein, whereby opposite ends of the surgical suture are threaded through the wings 361 such that the ends of the surgical suture are pulled out of a patient's body by being caught by a needle that is pierced into a patient's body from outside.
- closure cartridge 36 is already known to those skilled in the art by the inventor's prior patent, so the detailed description of the configuration thereof will be skipped, and the operation process thereof will be described in detail hereinafter.
- the present invention may be realized by modifying the structure of the replaceable penetrating tip 37, and by modifying the assembly structure of the cover rods 34 facing each other.
- the penetrating tip 37 may be configured such that a pointed end 371 is provided with inner threads 375 at an inside thereof and a protruding piece 346 of the cover rod 34 is provided with outer threads 346a, so as to be fixedly inserted into a lower portion of the cover rod 34 by the inner threads 375 being engaged with the outer threads 346a (see FIG. 13 ).
- the penetrating tip 37 may be configured such that a pointed end 371 is provided with an inner groove 375b at an inside thereof and a protruding piece 346 of the cover rod 34 is provided with an outer protrusion 346b, so as to be fixedly inserted into a lower portion of the cover rod by the inner groove being engaged with the outer protrusion (see FIG. 14 ).
- the laparoscopic port perforation and closure device of the present invention serves as a trocar that opens and maintains an operative pathway mainly through a patient's peritoneum.
- the laparoscopic port perforation and closure device of the present invention opens a surgical port and closes the opened port.
- the penetrating tip 37 is locked to the lowermost portion of the cover rod 34 of the perforation/closure assembly 3 of the present invention.
- the penetrating tip 37 is firmly locked in such a manner that the neck 372 having a linear guide groove 372a and a locking groove 372b is inserted into the neck entrance 303 of the lower portion of the cover rod 34, and the holder 35 is rotated in a direction such that the lower protruding portion 354 of the holder is engaged with the locking groove 372b of the penetrating tip 37.
- the reason why the protrusion 347 of the protruding piece 346 is inserted at a predetermined angle while guiding the guide groove 372a of the penetrating tip 37 when the neck 372 enters is to align the lower protruding portion 354 of the holding rod 351 and the locking groove 372b of the penetrating tip 37 to be engaged with each other, and this insertion induction action is also applied when the closure cartridge 36 is coupled and separated.
- the one-touch hook 32 is disengaged and the perforation/closure assembly 3 is removed from the trocar 4.
- the penetrating tip 37 coupled to the lower portion of the removed perforation/closure assembly 3 is removed and the closure cartridge is coupled thereto for closing the port.
- the holding rod 351 is reversely rotated to the groove (from 345b to 345a) such that the lower protruding portion 354 and the locking groove 372b are disengaged from each other, whereby the penetrating tip 37 is removed by pulling it.
- the neck 362 of the closure cartridge 36 is pushed into the lower portion of the perforation/closure assembly 3 with the penetrating tip removed therefrom, and is locked thereto by rotating the holding rod 351.
- the perforation/closure assembly 3 with the closure cartridge 36 coupled thereto is inserted into the trocar 4 inserted through the peritoneum, and then the holding rod 351 is pulled upward, the upper protruding portion 353 is moved upward along the groove 345b of the crank-shaped groove 345.
- the wings 361 are opened horizontally, and when the holding rod 351 is further rotated, the upper protruding portion 353 is engaged with the groove 345c, thereby preventing the holding rod 351 from being moved downward such that the opened wings 361 is prevented from being closed.
- the closure cartridge 36 is configured such that the compartment thereof receives the rolled surgical suture therein, and the opposite ends of the surgical suture are threaded through the wings 361, whereby the ends of the surgical suture are pulled outside a patient's body by being caught by a needle pierced into the needle.
- suturing is performed in such a manner that a cap of the handle 42 of the trocar 4 is opened and the suturing needle is stuck thereinto, then the needle passes through the sleeve 41 along the helical needle guide groove 341 and reaches the opened wings 361, an end of the surgical suture provided in the wings is caught by the needle 39 and pulled outside the patient's body, and from the opposite direction, the needle is stuck thereinto and the above process is repeated, the wings 361 are closed by reversely rotating the holding rod 351 such that the perforation/closure assembly 3 is removed from the sleeve 41, the surgical suture is tied to close the port.
- the trocar 4 inserted through a different site is closed by the above manner.
- the closure cartridge 36 is coupled to the device by replacing the used the closure cartridge with a new one and is inserted into the peritoneum to close the port, whereby all of the ports can be closed.
- the penetrating tip is configured such that the pointed end 371 is provided with the inner threads 375 at the inside thereof, and the protruding piece 346 of the cover rod 34 is provided with the outer threads 346a so as to be fixedly inserted into the lower portion of the cover rod 34 by the inner threads 375 being engaged with the outer threads 346a, the coupling and separation are performed not by the locking groove 372b but by the inner threads 375 being engaged with the outer threads 346a.
- the penetrating tip 37 may be configured such that the pointed end 371 is provided with the inner groove 375b at the inside thereof, and the protruding piece 346 of the cover rod 34 is provided with the outer protrusion 346b, so as to be fixedly inserted into the lower portion of the cover rod by a horizontal groove of the inner groove 375b being engaged with the outer protrusion 346b.
- the penetrating tip 37 can be adopted as long as it is firmly coupled to and easily removed from the lower end of the cover rod 34, and any structure that is convenient to use in the surgical field and cannot be easily separated during surgery can be applied, and variations thereof are not limited to a predetermined shape. It is understood by those skilled in the art that various changes and modifications may be made in the invention without departing from the spirit and scope thereof
- the port opening and closure described above are performed by using the perforation/closure assembly 3, wherein the penetrating tip 37 or the closure cartridge 36 is selectively coupled to the lower end thereof so that the perforation/closure assembly can be used in combination, a plurality of ports of trocars is closed by coupling the closure cartridge 36, whereby the operation time is shortened, and the number of tools for opening and closing the port is reduced, so it is economical.
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Abstract
Description
- The present invention relates generally to a laparoscopic port perforation and closure device. More particularly, the present invention relates to a laparoscopic port perforation and closure device configured such that a perforation device for perforating a laparoscopic port on a patient's body, a trocar for maintaining the port and allowing various surgical tools to be introduced therethrough, and a closure device for closing the port are selectively used in a single trocar assembly.
- In general, laparoscopic surgery, unlike conventional open surgical procedures, refers to a surgical technique where four to six incisions about 0.5∼1.2cm in size are made in the patient's abdomen, and trocars, which have a diameter of 0.5∼1.2cm and are 15∼16cm long, are placed through these incisions. A light source, a camera, and surgical instruments are then introduced into the abdomen through the trocars. The surgeon performs the procedure, watching a television monitor to which the camera transmits an image of the organs inside the abdomen.
- For laparoscopic surgery, after a plurality of trocars is placed into a patient's abdomen, carbon dioxide gas is used to inflate the abdomen through one of the trocars in order to give the surgical space to work. The endoscope and surgical instruments are then introduced through other trocars. The surgeon performs a surgery for the affected area, monitoring the surgical site.
- After the procedure, in order to close the incisions, a trocar site closure tool is used. The trocar site closure tool is configured such that the incisions are closed by stitching while the needle is held by the forceps that are placed into the abdominal cavity through the trocar. After closing the incisions, in order to prevent the stitches from being untied, opposite ends of the surgical suture are pulled out of the patient's body through the trocar, and the knots are tied outside the patient's body. After tying the knots, the knots are formed into the abdominal cavity by pushing the knots using a compressor.
- After the surgical site inside the abdominal cavity is treated, the trocar is removed and the port is closed.
- Port closure can be done by direct suturing or by using a closure device.
- According to a conventional art, the perforation of the port by the trocar secures the operative pathway, and the closure of the port by the closure device is performed by using a separate device.
- As shown in
FIG. 1 , a trocar is used to form a surgical port site, thetrocar 10 includes: atubular sleeve 14 with apenetrating tip 16 penetrating therethrough; and ahandle 12 provided at an upper portion of the sleeve, wherein an end of the penetratingtip 16 is constituted by apointed end 16a to penetrate through subcutaneous tissue of an abdominal cavity, whereby after perforating a port, the penetrating tip is removed, various surgical tools are introduced through thetrocar 10 to perform surgery. - After the surgery, the
trocar 10 is removed and the port is closed by using a closure device as shown inFIG. 2 . - The closure device shown in
FIG. 2 is well known to those skilled in the art, and the use thereof is gradually increasing since it provides safety allowing rapid closure of the port without failure. - The closure device is also known as a fascial closure device.
- The fascial closure device, which is in a tube shape for being introduced into a port site, includes: a
tubular body 21 formed withguide groove 22 that face each other and guide insertion of aneedle 23; and a pair ofwings 25 being mounted to a lower portion of the tubular body, and being opened and closed using cam method, wherein each of the wings is provided with asilicon pad 26 at a location where theneedle 23 penetrates through, and thewings 25 are configured to be opened by rotating anoperating stick 24 and configured to be closed by reversely rotating the operating stick 4. - The inventor of the present invention filed the document a laparoscopic port site closure device, which has a new structure that improves disadvantages of a conventional closure device, and it is registered as Korean Patent No.
1594082 - According to the above document of the inventor, the laparoscopic port site closure device is configured such that a cartridge receiving a surgical suture therein is provided at a fore-end of a needle guide for port site closure; the surgical suture is caught in a needle tip that is pierced through a body tissue by being guided by the needle guide; and when the needle is withdrawn, the surgical suture is pulled out along a path through which the needle is pierced into the tissue, and the surgical suture is tied outside a patient's body, thereby being capable of closing a laparoscopic port site. The closure device includes: a tubular body provided with needle guides that face each other and guide insertion of a needle; wings mounted to a lower portion of the tubular body such that the wings are opened and closed through a cam method; and an operating stick penetrating through the tubular body to operate the wings by being rotated to push and open the wings and to pull and close the wings by being rotated reversely, wherein a replaceable cartridge is provided on a lower end of the tubular body to be detachably combined with the operating stick, and the cartridge is provided with the wings capable of being opened by operating the operating stick, and provided with a compartment for receiving surgical suture therein, whereby opposites ends of the surgical suture in the compartment are threaded through the wings such that the ends of the surgical suture are pulled out of a patient's body by being caught by a suture slot of a needle that is pierced into the patient's body from outside.
- According to the inventor's document of the prior patent, the cartridge receiving a surgical suture therein is replaceable, whereby the port site can be easily closed without failure, and the closure device is reusable by replacing the cartridge receiving the surgical suture therein. However, since the conventional closure device including the prior patent is limited to a closure device that simply closes an opened port, port opening and port closure are performed through different devices.
- Since opening and closure are performed by different devices, when the fascial closure device (the closure device) is introduced through the port site after removing the trocar to after surgery, the gas injected inside the abdominal cavity overly escapes, whereby the surgical space narrows so it is difficult to perform a follow-up treatment, the operation time may be long due to removal of the trocar and the replacement of the fascial closure device, which is an obstacle to the patient's prognosis.
- Accordingly, the present invention has been made to solve the above problem occurring in the related art that a function of the trocar and a function of the closure device are divided.
- The present invention is intended to propose a laparoscopic port perforation and closure device, in which a perforation/closure assembly being introduced in the abdominal cavity through a trocar sleeve is provided, thereby serving as both perforation of a peritoneum and closure of the opened port.
- The present invention is intended to propose a laparoscopic port perforation and closure device, in which a perforation/closure assembly replaced with a closure cartridge is inserted into a trocar sleeve without removing a trocar to suture, such that the reverse flow of the gas injected inside the abdominal cavity is minimized, whereby it is advantageous to stably secure the surgical space and suturing time may be shortened.
- The present invention is intended to propose a laparoscopic port perforation and closure device, in which an end of the body of the laparoscopic port perforation and closure device is provided with a detachable cartridge, such that the cartridge is replaceable after being repeatedly used, whereby it is easy to use and there is no risk of infection because it is discarded after reuse for the same patient.
- In order to achieve the above object, according to one aspect of the present invention, there is provided a laparoscopic port site closure device configured as follows.
- The perforation and closure device includes: a trocar configured such that a handle is coupled to a first end of a sleeve formed in a tubular shape for being introduced into a perforated port; a perforation and closure means hooked to the handle of the trocar and configured such that an end tip thereof enters an abdominal cavity by sequentially penetrating the handle and the sleeve of the trocar.
- The perforation and closure means may include: a hooked to the handle of the trocar; a bisected cover rod longitudinally extending from the handle; a holder provided therein and configured to rotate within a limited angle range in the cover rod and move up and down within a limited distance; a closure cartridge inserted into and locked to a lower portion of the cover rod; and a penetrating tip inserted into and locked to the lower portion of the cover rod or inserted into the lower portion of the cover rod and locked thereto by the holder, whereby the closure cartridge and the penetrating tip are selectively coupled to the perforation and closure device and are replaceable.
- The cover rod may be formed with helical needle guide grooves at an outer circumferential surface thereof.
- The penetrating tip may be provided with a pointed end to be coupled to an end of the cover rod, and an outer diameter of the penetrating tip may correspond to an outer diameter of the cover rod.
- The closure cartridge may include: wings coupled to an end of the cover rod and controlled by the holder to be opened and closed; and a compartment receiving a surgical suture therein, whereby opposite ends of the surgical suture are threaded through the wings such that the ends of the surgical suture are pulled out of a patient's body by being caught by a needle that is pierced into a patient's body from outside.
- According to the present invention having the above-described characteristics, the port opening function of trocar and the port closing function of the closure device are conventionally realized by the respective devices, but it is possible to realize the port opening and the port closing through a single device.
- The present invention is advantageous in that it is possible to serve as both perforation of a peritoneum and closure of the opened port after surgery through a perforation/closure assembly that is firmly coupled and easily replaceable.
- The present invention is further advantageous in that it is possible to solve the problem that the gas injected inside the abdominal cavity flows out through the port when a separate closure device is inserted to close the port after removing the trocar.
- In other words, since the present invention is configured such that a perforation/closure assembly replaced with a closure cartridge is inserted into a trocar sleeve without removing a trocar to suture, the reverse flow of the gas injected inside the abdominal cavity is minimized, whereby it is advantageous to secure the surgical space constantly and suturing time may be shortened.
- The present invention is further advantageous in that since an end of the body of the laparoscopic port perforation and closure device is provided with a detachable cartridge, the cartridge is replaceable after being repeatedly used, whereby it is easy to use and there is no risk of infection because it is discarded after reuse for the same patient.
-
-
FIG. 1 exemplarily shows an outside view of a trocar as a conventional laparoscopic port site perforation device; -
FIG. 2 exemplarily shows an outside view of a closure tool as a laparoscopic port site closure device; -
FIG. 3 shows an exploded perspective view of a laparoscopic port perforation and closure device including a perforation/closure assembly of the present invention; -
FIG. 4 shows a schematic view of essential portions of the perforation/closure assembly of the present invention; -
FIG. 5 shows a plane view of the perforation/closure assembly shown inFIG. 4 ; -
FIG. 6 shows a plane state view and a front state view of a penetrating tip of the present invention; -
FIG. 7 shows a plane state view and a front state view of a closure cartridge of the present invention; -
FIG. 8 shows an operational state view of essential portions showings the perforation/closure assembly of the present invention; -
FIGS. 9 shows operational views of a state where the penetrating tip is detached from and coupled to the device by a lock/unlock constraint part ofFIG. 8 ; -
FIGS. 10 shows operational views of a state where the closure cartridge is detached from and coupled to the device by the lock/unlock constraint part ofFIG. 8 ; -
FIG. 11 shows an operational view of a state where the penetrating tip of the present invention is detached from and coupled to the device; -
FIG. 12 shows an operational view of a state where the closure cartridge of the present invention is detached from and coupled to the device; and -
FIGS. 13 to 14 show schematic views of modification of penetrating tip of the present invention. - Hereinbelow, a detailed configuration and operation of the present invention will be described with reference to the accompanying drawings.
- In a trocar configured such that a handle is coupled to a first end of a sleeve formed in a tubular shape for being introduced into a perforated port, a penetrating tip is configured such that an end tip thereof is exposed outside a second end of the sleeve by sequentially penetrating the handle and the sleeve of the trocar to enter an abdominal cavity, and a perforation and closure means is configured to be coupled to a closure cartridge by removing the penetrating tip and coupled to the handle of the trocar by a one-touch hook.
- The perforation and closure means is constituted by a combined perforation/
closure assembly 3 detachably mounted to the trocar and configured such that the penetrating tip is coupled to an end thereof when opening (perforating) a port, and the closure cartridge is coupled to the end thereof when closing (suturing) the port. - The perforation/
closure assembly 3 includes: ahandle cover 31 coupled to the handle of the trocar by a one-touch hook 32; a bisectedcover rod 34 longitudinally extending from thehandle 33; aholder 35 provided therein and configured to rotate within a limited angle range in thecover rod 34 and move up and down within a limited distance; aclosure cartridge 36 inserted into and locked to a lower portion of thecover rod 34; and a penetratingtip 37 inserted into and locked to the lower portion of thecover rod 34 or inserted into the lower portion of thecover rod 34 and locked thereto by theholder 35, whereby theclosure cartridge 36 and the penetratingtip 37 are selectively coupled to the perforation and closure device and are replaceable. - The
cover rod 34 is formed with a helicalneedle guide groove 341 at an outer circumferential surface thereof, and a plurality of thecover rods 34 is disposed to face each other and coupled to thehandle cover 31 provided with the one-touch hook 32 therein. - The
cover rod 34 is configured such that upper and lower portions thereof are respectively provided with a coupling hook 342 and a coupling groove 343 to face each other, a plurality of the cover rods is coupled to face each other, and thecover rod 34 is provided with theholder 35 therein. - The
cover rod 34 is provided with a crank-shaped groove 345 at an inner upper portion thereof to form a lock/unlock constraint part 300, is provided with a step at an inner middle portion thereof to form a downward-motion constraint part 301, is provided with a step at an inner lower portion thereof to form a upward-motion constraint part 302, and is provided with a protrudingpiece 346 having aninner protrusion 347 at a lowermost portion thereof, thereby being formed in a tubular shape to form aneck entrance 303 at a lower end thereof when the cover rods are assembled to face each other. - The
holder 35 includes: a holdingrod 351 provided with astep 352 under the handle with an upper diameter thereof large and a lower diameter thereof small; upper and lower protrudingportions stopper 355 provided to protrude in a disc shape at a location right above the lower protruding portion. - The upper protruding
portion 353 of the holdingrod 351 is engaged with a crank-shaped groove 345 of thecover rod 34, thestep 352 is disposed at an upper portion of a downward-motion constraint part 301 to constrain downward-motion, thestopper 355 is disposed at a lower portion of an upward-motion constraint part 302 to constrain upward-motion, and an up-and-down moving distance of the holdingrod 351 is constrained by the crank-shaped groove 345 and the upward-motion and downward-motion constraint parts - The crank-shaped groove 345 constitutes a lock/
unlock constraint part 300 horizontally rotating at a location where the holdingrod 351 moves up or down for locking and unlocking the same. - The penetrating
tip 37 is provided with apointed end 371 and aneck 372 longitudinally extending upward at a center thereof to be detachably coupled to an end of thecover rod 34, and it is preferred that an outer diameter of the penetrating tip correspond to an outer diameter of the cover rod. - The
closure cartridge 36 includes:wings 361 detachably coupled to an end of thecover rod 34 by inserting aneck 362 thereinto and controlled by theholder 35 to be opened and closed; and a compartment receiving a surgical suture therein, whereby opposite ends of the surgical suture are threaded through thewings 361 such that the ends of the surgical suture are pulled out of a patient's body by being caught by a needle that is pierced into a patient's body from outside. - The
closure cartridge 36 is already known to those skilled in the art by the inventor's prior patent, so the detailed description of the configuration thereof will be skipped, and the operation process thereof will be described in detail hereinafter. - The present invention may be realized by modifying the structure of the replaceable penetrating
tip 37, and by modifying the assembly structure of thecover rods 34 facing each other. - The penetrating
tip 37 may be configured such that apointed end 371 is provided with inner threads 375 at an inside thereof and aprotruding piece 346 of thecover rod 34 is provided withouter threads 346a, so as to be fixedly inserted into a lower portion of thecover rod 34 by the inner threads 375 being engaged with theouter threads 346a (seeFIG. 13 ). - Further, the penetrating
tip 37 may be configured such that apointed end 371 is provided with aninner groove 375b at an inside thereof and aprotruding piece 346 of thecover rod 34 is provided with anouter protrusion 346b, so as to be fixedly inserted into a lower portion of the cover rod by the inner groove being engaged with the outer protrusion (seeFIG. 14 ). - Reference will be made in greater detail to the present invention configured as described above.
- As known to those skilled in the art, the laparoscopic port perforation and closure device of the present invention serves as a trocar that opens and maintains an operative pathway mainly through a patient's peritoneum.
- The laparoscopic port perforation and closure device of the present invention opens a surgical port and closes the opened port.
- Firstly, reference will be made to the opening procedure shown in
FIGS. 9 and11 . - To open the port, the penetrating
tip 37 is locked to the lowermost portion of thecover rod 34 of the perforation/closure assembly 3 of the present invention. - The penetrating
tip 37 is firmly locked in such a manner that theneck 372 having alinear guide groove 372a and a lockinggroove 372b is inserted into theneck entrance 303 of the lower portion of thecover rod 34, and theholder 35 is rotated in a direction such that the lower protrudingportion 354 of the holder is engaged with the lockinggroove 372b of the penetratingtip 37. - The reason why the
protrusion 347 of the protrudingpiece 346 is inserted at a predetermined angle while guiding theguide groove 372a of the penetratingtip 37 when theneck 372 enters is to align the lower protrudingportion 354 of the holdingrod 351 and the lockinggroove 372b of the penetratingtip 37 to be engaged with each other, and this insertion induction action is also applied when theclosure cartridge 36 is coupled and separated. - When the
neck 372 of the penetratingtip 37 is inserted deeply into theneck entrance 303 and the holdingrod 351 is rotated, the lower protrudingportion 354 is engaged with the lockinggroove 372b and at the same time, the upper protrudingportion 353 is moved to a groove of the crank-shaped groove 345 (moved from 345a to 345b), and the penetrating tip and the end of thecover rod 34 are brought into contact with each other, whereby the upward and downward motion of the holdingrod 351 is constrained by not being moved to a direction of thegroove 345c and the locking of the penetratingtip 37 is completed. - When the perforation/
closure assembly 3 with the penetratingtip 37 being locked thereto is coupled to the trocar 4, the one-touch hook 32 is hooked to theconnector 5, whereby the preparation for inserting the trocar into the abdominal cavity is completed. - It is well known to grip and insert the perforation/
closure assembly 3 coupled to the trocar 4 into the incised peritoneum by pressing the same. - After inserting the trocar into the abdominal cavity, the one-
touch hook 32 is disengaged and the perforation/closure assembly 3 is removed from the trocar 4. - After that, it is also well known that surgery is performed through the trocar 4.
- When the operation is completed, the penetrating
tip 37 coupled to the lower portion of the removed perforation/closure assembly 3 is removed and the closure cartridge is coupled thereto for closing the port. To achieve this, the holdingrod 351 is reversely rotated to the groove (from 345b to 345a) such that the lower protrudingportion 354 and the lockinggroove 372b are disengaged from each other, whereby the penetratingtip 37 is removed by pulling it. - As shown in
FIGS. 12 and10 , theneck 362 of theclosure cartridge 36 is pushed into the lower portion of the perforation/closure assembly 3 with the penetrating tip removed therefrom, and is locked thereto by rotating the holdingrod 351. - The perforation/
closure assembly 3 with theclosure cartridge 36 coupled thereto is inserted into the trocar 4 inserted through the peritoneum, and then the holdingrod 351 is pulled upward, the upper protrudingportion 353 is moved upward along thegroove 345b of the crank-shaped groove 345. Here, as the groove of thewings 361 is guided to theprotrusion 347 of the protrudingpiece 346, thewings 361 are opened horizontally, and when the holdingrod 351 is further rotated, the upper protrudingportion 353 is engaged with thegroove 345c, thereby preventing the holdingrod 351 from being moved downward such that the openedwings 361 is prevented from being closed. - The specific configuration and the operation of the
closure cartridge 36 are already mentioned in the document of the inventor's prior patent. - Briefly, the
closure cartridge 36 is configured such that the compartment thereof receives the rolled surgical suture therein, and the opposite ends of the surgical suture are threaded through thewings 361, whereby the ends of the surgical suture are pulled outside a patient's body by being caught by a needle pierced into the needle. - Accordingly, suturing is performed in such a manner that a cap of the
handle 42 of the trocar 4 is opened and the suturing needle is stuck thereinto, then the needle passes through thesleeve 41 along the helicalneedle guide groove 341 and reaches the openedwings 361, an end of the surgical suture provided in the wings is caught by theneedle 39 and pulled outside the patient's body, and from the opposite direction, the needle is stuck thereinto and the above process is repeated, thewings 361 are closed by reversely rotating the holdingrod 351 such that the perforation/closure assembly 3 is removed from thesleeve 41, the surgical suture is tied to close the port. - The trocar 4 inserted through a different site is closed by the above manner. Here, the
closure cartridge 36 is coupled to the device by replacing the used the closure cartridge with a new one and is inserted into the peritoneum to close the port, whereby all of the ports can be closed. - As shown in
FIG. 13 , in the case where the penetrating tip is configured such that thepointed end 371 is provided with the inner threads 375 at the inside thereof, and the protrudingpiece 346 of thecover rod 34 is provided with theouter threads 346a so as to be fixedly inserted into the lower portion of thecover rod 34 by the inner threads 375 being engaged with theouter threads 346a, the coupling and separation are performed not by the lockinggroove 372b but by the inner threads 375 being engaged with theouter threads 346a. - Further, as shown in
FIG. 14 , the penetratingtip 37 may be configured such that thepointed end 371 is provided with theinner groove 375b at the inside thereof, and the protrudingpiece 346 of thecover rod 34 is provided with theouter protrusion 346b, so as to be fixedly inserted into the lower portion of the cover rod by a horizontal groove of theinner groove 375b being engaged with theouter protrusion 346b. - Unlike the
closure cartridge 36, the penetratingtip 37 can be adopted as long as it is firmly coupled to and easily removed from the lower end of thecover rod 34, and any structure that is convenient to use in the surgical field and cannot be easily separated during surgery can be applied, and variations thereof are not limited to a predetermined shape. It is understood by those skilled in the art that various changes and modifications may be made in the invention without departing from the spirit and scope thereof - The port opening and closure described above are performed by using the perforation/
closure assembly 3, wherein the penetratingtip 37 or theclosure cartridge 36 is selectively coupled to the lower end thereof so that the perforation/closure assembly can be used in combination, a plurality of ports of trocars is closed by coupling theclosure cartridge 36, whereby the operation time is shortened, and the number of tools for opening and closing the port is reduced, so it is economical. -
- 3: perforation/closure assembly 31: handle cover
- 32: one-touch hook 33: handle
- 34: cover rod 35: holder
- 36: closure cartridge 37: penetrating tip
- 300: lock/unlock constraint part 301: downward-motion constraint part
- 302: upward-motion constraint part 303: neck entrance
- 341: needle guide groove 342: coupling hook
- 343: coupling groove 345: crank-shaped groove
- 346: protruding
piece 346a: outer threads - 346b: outer protrusion 347: protrusion
- 351: holding rod 352: step
- 353: upper protruding portion 354: lower protruding portion
- 355: stopper 361: wings
- 362, 372:
neck - 362b, 372b: locking groove 371: pointed end
- 375a:
inner threads 375b: inner groove
Claims (9)
- A laparoscopic port perforation and closure device comprising:a trocar (4) configured such that a handle is coupled to a first end of a sleeve formed in a tubular shape for being introduced into a perforated port;a connector (5) detachably coupled to an upper portion of the handle of the trocar;a penetrating tip (37) hooked to the connector, with an end tip thereof being exposed outside a second end of the sleeve by sequentially penetrating the handle and the sleeve of the trocar, and configured to enter an abdominal cavity by perforating a port; anda combined perforation/closure assembly (3) configured to close the perforated port by replacing the penetrating tip (37) with a closure cartridge (36).
- The perforation and closure device of claim 1, wherein
the perforation/closure assembly (3) includes: a bisected cover rod (34) longitudinally extending from the handle (33); a holder (35) provided in the perforation/closure assembly and configured to be rotated within a limited angle range in the cover rod (34) and moved up and down within a limited distance; the closure cartridge (36) inserted into and locked to a lower portion of the cover rod (34); and the penetrating tip (37) inserted into and locked to the lower portion of the cover rod (34),
whereby any one of the closure cartridge (36) and the penetrating tip (37) is selectively coupled to the perforation and closure device, and the closure cartridge and the penetrating tip are repeatedly used by replacing the same. - The perforation and closure device of claim 2, wherein
the cover rod (34) is formed with a helical needle guide groove (341) at an outer circumferential surface thereof, and is provided in plural such that the plurality of cover rods (34) is disposed to face each other and is coupled to a handle cover (31) provided with a one-touch hook (32) therein. - The perforation and closure device of claim 2, wherein
the cover rod (34) is configured such that upper and lower portions thereof are respectively provided with a coupling hook (342) and a coupling groove (343) to face each other,
the cover rod (34) is provided in plural such that the plurality of cover rods is coupled to face each other, and the cover rods (34) are provided with the holder (35) therein, and
the cover rod (34) is provided with a crank-shaped groove (345) at an inner upper portion thereof to form a lock/unlock constraint part (300), is provided with a step at an inner middle portion thereof to form a downward-motion constraint part (301), is provided with a step at an inner lower portion thereof to form a upward-motion constraint part (302), and is provided at a lowermost portion thereof with a protruding piece (346) having an inner protrusion (347), thereby being formed in a tubular shape to form a neck entrance (303) at a lower end thereof when the cover rods are assembled to face each other. - The perforation and closure device of claim 2, wherein
the holder (35) includes: a holding rod (351) provided with a step (352) under the handle with a large upper diameter thereof and a small lower diameter thereof; upper and lower protruding portions (353, 354) provided at upper and lower portions of the holding rod; and a stopper (355) provided to protrude in a disc shape at a location right above the lower protruding portion,
the upper protruding portion (353) of the holding rod (351) is engaged with a crank-shaped groove (345) of the cover rod (34), the step (352) is disposed at an upper portion of a downward-motion constraint part (301) to constrain downward-motion of the holding rod, the stopper (355) is disposed at a lower portion of an upward-motion constraint part (302) to constrain upward-motion of the holding rod, and an up-and-down moving distance of the holding rod (351) is constrained by the crank-shaped groove (345) and the upward-motion and downward-motion constraint parts (302, 301), and
the crank-shaped groove (345) constitutes a lock/unlock constraint part (300) horizontally rotating at a location where the holding rod (351) moves up or down for locking or unlocking the same. - The perforation and closure device of claim 2, wherein
the penetrating tip (37) is provided with a pointed end (371) and a neck (372) longitudinally extending upward at a center thereof to be detachably coupled to an end of the cover rod (34), and an outer diameter of the penetrating tip corresponds to an outer diameter of the cover rod. - The perforation and closure device of claim 2, wherein
the closure cartridge (36) includes: wings (361) detachably coupled to an end of the cover rod (34) by inserting a neck (362) thereinto and controlled by the holder (35) to be opened and closed; and a compartment receiving a surgical suture therein,
whereby opposite ends of the surgical suture are threaded through the wings (361) such that the ends of the surgical suture are pulled out of a patient's body by being caught by a needle that is pierced into a patient's body from outside. - The perforation and closure device of claim 2, wherein
the penetrating tip (37) is configured such that inner threads (375) are provided at locations inside a pointed end (371) thereof, and outer threads (346a) are provided on a protruding piece (346) of the cover rod (34), so the penetrating tip is fixedly inserted into a lower portion of the cover rod (34) by engagement of the inner threads (375) and the outer threads (346a). - The perforation and closure device of claim 2, wherein
the penetrating tip (37) is configured such that an inner groove (375b) is provided at a location inside a pointed end (371) thereof, and an outer protrusion (346b) is provided on a protruding piece (346) of the cover rod (34), so the penetrating tip is fixedly inserted into a lower portion of the cover rod (34) by engagement of the inner groove and the outer protrusion.
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KR1020160100005A KR101712611B1 (en) | 2016-08-05 | 2016-08-05 | Laparoscopic port site opening and closing apparatus |
PCT/KR2016/010069 WO2018026050A1 (en) | 2016-08-05 | 2016-09-08 | Laparoscopic port site opening and closing device |
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EP3308721A4 EP3308721A4 (en) | 2019-03-27 |
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CN113520542B (en) * | 2021-06-24 | 2023-03-31 | 浙江优亿医疗器械股份有限公司 | Laparoscope puncture outfit with fascia closing function |
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- 2016-08-05 KR KR1020160100005A patent/KR101712611B1/en active IP Right Grant
- 2016-09-08 WO PCT/KR2016/010069 patent/WO2018026050A1/en active Application Filing
- 2016-09-08 US US15/555,395 patent/US10492824B2/en active Active
- 2016-09-08 JP JP2017545628A patent/JP6497600B2/en not_active Expired - Fee Related
- 2016-09-08 CN CN201680013133.XA patent/CN109069142A/en not_active Withdrawn
- 2016-09-08 EP EP16891904.1A patent/EP3308721B1/en active Active
Also Published As
Publication number | Publication date |
---|---|
WO2018026050A1 (en) | 2018-02-08 |
US10492824B2 (en) | 2019-12-03 |
JP2018526038A (en) | 2018-09-13 |
EP3308721B1 (en) | 2020-11-04 |
EP3308721A4 (en) | 2019-03-27 |
KR101712611B1 (en) | 2017-03-06 |
CN109069142A (en) | 2018-12-21 |
JP6497600B2 (en) | 2019-04-10 |
US20190142454A1 (en) | 2019-05-16 |
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